Your are so right. I will say though that when a guy comes on here and says their Doc prescribed an AI of 1 mg per day when their e2 wasn’t even tested or it’s already low, I will say that Dr is stupid.
There are guys on here that preach the same nonsense and from what I read they may not even have experienced it themselves.
I like to here people’s own experiences and on occasion advice on what they would do in my situation if they have experienced similar.
The worst thing is that a guy in their 20s reads comments and think they should go on trt instantly. When the root cause should def be throughly investigated esp when that young. Testicular cancer is most common when young.
Also pituitary MRI should be considered at times.
This was mentioned by someone else in here that I like, but some guys read on here and start chasing e2= 22,like I did, And end up in a nightmare with getting to that number.
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Absolutely. When I read that some of these docs prescribe an AI off the top it blows my mind. Also, When a patient comes in and presents with any hormone wildly out of range the next step is a pituitary MRI.
The most valuable tool in this entire game is patient feedback. The majority of my patients are not on an AI. Do some guys need one? Sure. That’s after we’ve examined their liver functions, tested for gene mutations, monitored labs for 12 weeks, and toyed around after with injection protocols and dosages.
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I think my easiest protocol switch for the moment could be the following:
Change hcg to EOD 500iu (started today)
Bump Test cyp to 120mg 2 times a week.
After all I’m not worried about E running wild I want more.
In the mean time I’ll consult with doc and fellow and pitch the test prop Vs cyp EOD. If he goes for the prop it’ll take time to get it in.
What’s the comparable dose for test prop EOD? I’d like to have some different options to throw at him.
1- bump total cyp dose Higher
Vs
2- cyp EOD or everyday
Vs
3-prop eod or everyday
I’ve read a few of your posts on T:E ratio. What’s your range and your formula that you use?
Also reading about injection irritation with sub q prop. What say you?
If your goal is to increase e levels, don’t inject sub q. There is no formula - god I wish there was - it’s all super patient dependant. Hormone levels on their own don’t dictate mood - it’s their effects in neurotransmitters downstream that do. Every single patient is unique so that the most valuable tool we have is discussion and feedback - not directly always labs. I’ve been thinking about your situation and I’m curious as to if you’ve ever used tamoxifen on your protocol or switched to one shot of test e or c a week? I actually have a a few patients who respond best to one shot weekly of t and low dose tamoxifen daily. It’s way too hard to give concrete advice without sitting down and talking to you unfortunately. Test prop is great for eod injects and keeping your levels extremely stable and almost mimics body release (only better option is suspension but it’s really hard to get purity assured). I’m wondering though if someone in your shoes is better off with one shot a week.
I started out injecting 1 shot (200mg) per 7 days and would have fatigue ect at weeks ends. I guess it should have been every 5 days in reality so switched quickly to twice weekly.
Switching back to IM is a good idea and not drastic. But ouch.
I’ve been tossing around my next step.
With options being: more frequent lower dosing
Or large less frequent dosing it seems the strategies are total oppposite.
Kind of just riding things out hoping my libido swings back so I can grab some labs and compare non-libido with great libido labs.
Could be an option and if for some reason my E miraculously swings to high I can drop the total dose?
Guess every 5 days is best with this protocol?
Yea that makes good sense to me. Again there are so many factors at play the best option you have is trial and error. Remember when you make a change - give it two-theee weeks to see how the effects you. That’s about the time it takes for neurological effects to occur. Also when e is crashed it can take months and months to rebuild. So be patient man. I am sorry.
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Yeah ive been off dex for 6 months and will catch my libido every 10 days or so for 3-4 days. It’s pretty frustrating and terrible for my marriage.
I’ve had patients from other docs come in who have crashed with either Adex or aromasin. Some guys bounce back after a month or two. Other guys take 9-12 months. Bottom line though is that you will get better. You need to just keep trying. Remember very small changes and time are your best methods right now.
Thanks for the positivity. I think for now will go with following changes and give it a few weeks.
Hcg EOD 500iu
Switch injections to IM but stay twice per week
It’s the smallest change. If this doesn’t give me more stability I’ll consult my doc/fellow and run through different opinions.
The one large dose option is interesting. We will see.
I mapped things out in a calendar from my log. Over the last 3 months I’ll catch libido every 15-18 days and it lasts for maybe 4-5 days.
What’s this telling me? To wide of swings?
How many other factors do you chart? Sleep? Caffeine? Does your diet change? Some of my low libido guys always feel better after an increase in carbs due to serotonin elevating. You aren’t low Carb are you?
No not low carb 150ish gm per day though I have noticed sometimes libido is slightly better the day after a large cheat meal. My diet is pretty good. 40/35/25 protein, carb, fat. Diet has been fairly consistent over the last year however I do plan to see my nutritionist soon to see if he can address this problem via diet. I’ve stayed 191lbs 8% bf for the entire year doing minimal cardio and cheating more than I like to admit on the weekends.
Caffeine 3 cups of coffee a day down from 4 over the last 2 weeks.
Sleep 7-8 good hours a night
That’s low carb in my circle man especially at that level of leanness. Up your carbs. I would bet money your serotonin is low.
10/4. Will increase carbs over the next few weeks to see how I respond. Headed to the bakery now!
Awesome. Gradually add 25-30 g a day until you’re closer to 250/300 g a day. Then let’s see how you feel 
You mean to tell me that extra 150gm at diner wasn’t healthy 
?
Regardless emailed doc. Really thinking I’d like to try daily injections. Waiting on reply, 2 years of complete inconsistency is just to much.
It’s more than hormones sir
Mind if I ask who your doctor is in Houston?